FillMapSmart Silver 22 Health

Does Smart Silver 22 Health cover testosterone?

Smart Silver 22 Health
13887-13887FL0010004-0 · ACA · ACA Marketplace
testosterone
testosteroneunder Smart Silver 22 Health
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$40per 30-day fill

From the first fill — no deductible on this drug.

This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.

Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
Tier
Generics
Approval first
Required
Try another first
No
Amount limit
Yes
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.

Covered forms and strengths (35)

  • 0.5 ML testosterone enanthate 100 MG/ML Auto-Injector [Xyosted]Approval firstAmount limit
  • 0.5 ML testosterone enanthate 150 MG/ML Auto-Injector [Xyosted]Approval firstAmount limit
  • 0.5 ML testosterone enanthate 200 MG/ML Auto-Injector [Xyosted]Approval firstAmount limit
  • 1 ML testosterone cypionate 200 MG/ML InjectionApproval firstAmount limit
  • 120 ACTUAT testosterone 10 MG/ACTUAT Topical GelApproval firstAmount limit
  • 120 ACTUAT testosterone 10 MG/ACTUAT Topical Gel [Fortesta]Approval firstAmount limit
  • 1250 MG testosterone 0.0162 MG/MG Topical GelApproval firstAmount limit
  • 1250 MG testosterone 0.0162 MG/MG Topical Gel [Androgel]Approval firstAmount limit
  • 24 HR testosterone 0.0833 MG/HR Transdermal System [Androderm]Approval firstAmount limit
  • 24 HR testosterone 0.167 MG/HR Transdermal System [Androderm]Approval firstAmount limit
  • 2500 MG testosterone 0.01 MG/MG Topical GelApproval firstAmount limit
  • 2500 MG testosterone 0.01 MG/MG Topical Gel [Androgel]Approval firstAmount limit
  • 2500 MG testosterone 0.0162 MG/MG Topical GelApproval firstAmount limit
  • 2500 MG testosterone 0.0162 MG/MG Topical Gel [Androgel]Approval firstAmount limit
  • 5000 MG testosterone 0.01 MG/MG Topical GelApproval firstAmount limit
  • 5000 MG testosterone 0.01 MG/MG Topical Gel [Androgel]Approval firstAmount limit
  • 5000 MG testosterone 0.01 MG/MG Topical Gel [Testim]Approval firstAmount limit
  • 5000 MG testosterone 0.01 MG/MG Topical Gel [Vogelxo]Approval firstAmount limit
  • 60 ACTUAT testosterone 12.5 MG/ACTUAT Topical GelApproval firstAmount limit
  • 60 ACTUAT testosterone 12.5 MG/ACTUAT Topical Gel [Vogelxo]Approval firstAmount limit
  • 60 ACTUAT testosterone 20.25 MG/ACTUAT Topical GelApproval firstAmount limit
  • 60 ACTUAT testosterone 20.25 MG/ACTUAT Topical Gel [Androgel]Approval firstAmount limit
  • 60 ACTUAT testosterone 30 MG/ACTUAT Topical SolutionApproval firstAmount limit
  • 60 ACTUAT testosterone 5.5 MG/ACTUAT Nasal Gel [Natesto]Approval firstAmount limit
  • testosterone cypionate 100 MG/ML Injectable SolutionApproval firstAmount limit
  • testosterone cypionate 100 MG/ML Injectable Solution [Depo-testosterone]Approval firstAmount limit
  • testosterone cypionate 200 MG/ML Injectable SolutionApproval firstAmount limit
  • testosterone enanthate 200 MG/ML Injectable SolutionApproval firstAmount limit
  • testosterone undecanoate 100 MG Oral Capsule [Kyzatrex]Approval firstAmount limit
  • testosterone undecanoate 112.5 MG Oral Capsule [Tlando]Approval firstAmount limit
  • testosterone undecanoate 150 MG Oral Capsule [Kyzatrex]Approval firstAmount limit
  • testosterone undecanoate 158 MG Oral Capsule [Jatenzo]Approval firstAmount limit
  • testosterone undecanoate 198 MG Oral Capsule [Jatenzo]Approval firstAmount limit
  • testosterone undecanoate 200 MG Oral Capsule [Kyzatrex]Approval firstAmount limit
  • testosterone undecanoate 237 MG Oral Capsule [Jatenzo]Approval firstAmount limit

← All coverage for testosterone